Active NPI
Carol Ann Tallman, M.D.
- Specialist
- Everett, WA
National Provider Identifier
1720192396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD00015742
- Practice address
- 3216 Norton Ave
Ste 101
Everett, WA 98201-4290 - Phone
- (425) 258-7511
- Fax
- (425) 258-7742
- NPI assigned
- Aug 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD00015742 | WA | Primary |
Addresses
Primary practice location
3216 Norton Ave
Ste 101
Everett, WA 98201-4290
Mailing address
3701 227TH St SW
Brier, WA 98036-8036
Phone (425) 258-7511
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1001031 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00015742 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720192396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3701 227TH ST SW",
"city": "BRIER",
"state": "WA",
"postal_code": "980368036",
"telephone_number": "425-258-7511",
"fax_number": "425-258-7742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3216 NORTON AVE",
"address_2": "STE 101",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014290",
"telephone_number": "425-258-7511",
"fax_number": "425-258-7742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TALLMAN",
"first_name": "CAROL",
"middle_name": "ANN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MD00015742",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1001031",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.